The promise of cell-based therapies in diabetes: A review of mesenchymal stem cell applications and trials

Diabetes mellitus, characterized by chronic hyperglycemia, presents a major global health burden with rising incidence worldwide. Current therapies often fail to achieve sustained glycemic control or halt disease progression, necessitating innovative strategies that target both metabolic dysfunction and autoimmune mechanisms in diabetes. Mesenchymal stem cells (MSCs) have garnered significant attention as a multifaceted therapeutic option, owing to their unique dual capabilities: tissue repair (via differentiation potential and paracrine effects) and immunomodulation (through cytokine secretion and immune cell regulation). This review comprehensively examines the therapeutic potential of MSCs in diabetes, covering: (1) mechanistic insights into how MSCs restore pancreatic β-cell function and mitigate insulin resistance; (2) preclinical evidence supporting their efficacy in both type 1 and type 2 diabetes models; and (3) critical analysis of ongoing clinical trials, including routes of administration, safety profiles, and metabolic outcomes. While promising results have been demonstrated in early-phase trials, we also discuss key challenges such as cell survival, standardization of protocols, and long-term therapeutic durability. By bridging current knowledge gaps with clinical translation needs, this review aims to provide a balanced perspective on MSC-based therapies for diabetes.